Sunday, July 31, 2016

While school staff are busy wrapping their minds around the end of summer and getting ready for back to school time, and parents are frantically trying to outfit their children with the "just right" back to school clothes and supplies, the Teachers Pay Teachers site is helping school staff and homeschoolers alike save money on back to school teaching supplies to make their jobs just that little bit - or a lot - easier.

"How,?" you might ask. By throwing their annual "Back 2 School" sale! This year the theme is "Together We're Better." The TPT site has been helping to make teachers, SLPs, parents and other who work with students be the best they can be. Speech Room News is sponsoring a blog linky with lots of great posts full of terrific sale deals from SLPs on TPT.

In my store, I try to provide resources primarily for those working with students who need to use augmentative-alternative communication (AAC). I have pre-made communication boards for a variety of contexts that are core-word based. I have interactive books to help teach and reinforce use of core vocabulary, and a variety of real-life experience simulations to use in intervention to augment the genuine communication opportunities that come up during the course of daily interactions.

I also offer a bunch of free handouts about AAC, to provide background information and getting-started help, among other topics.

I no longer do speech-language therapy, so I don't tend do shop for those products. I do make some resources for other SLPs to use in intervention; covering things like vocabulary growth, pragmatic language and syntax.
My purchases, however, tend to be mostly clip art. The students I work with tend to do best with images that are realistic, and there are some great offerings on TPT for art that I can use with those kids.

So, what's on my wish list for the coming sale? The Doodle Oven has this great set of historical figures that look very real, and will be great for Social Studies informational text resources.

Literature Daydreams and Illumismart both have some great clip art related to specific stories for older students, which I promised to make a focus for this year. So far, most of my book adaptations have been for elementary ages.

Away with the Pixels has great realistic clip art of kids and many animals. I just keep adding to my collection of her work. I've gotten loads of great comments after using one of her images on a Pin.

If I were in the market for speech-language therapy items, I'd probably head over to Looks Like Language for some great conversational and social language skills resources, Speech to the Core for some fun grammar and vocabulary resources, Speech Sprouts for fun preschool activities, Sarah Wu's Speech is Beautiful for bilingual resources (which are really useful here in Southern California), Beautiful Speech Life has some great concept building packages, AGB Speech Therapy has some great fun vocabulary and arctic resources, Alberta Speechie has some good-looking vocabulary and concepts products, Speech Therapy Fun has a ton of articulation resources, and Tamatha of TLC Talk Shop (who shares my passion for AAC, AT, and functional communication skills) has a variety of articulation, language, and social skills resources, too!

So, if you're looking to save some money on intervention and teaching products for the new school year, head on over. You'll find me here.

As I mentioned briefly last week, there are many AAC apps available in the iTunes store. I have given up counting them. I gave up somewhere before 200. And there are a few that have even disappeared.

However, for developing real communication skills, for developing genuine ability to say what they want, when they want, to whom they want, your AAC user needs a system that offers sufficient vocabulary to meet all of his/her communication needs, as well as to meet the needs of the communication partners who are using the system for Aided Language Stimulation across a wide variety of settings and situations. You need a robust vocabulary.

Now, this is where I often meet objection. “He only needs to be able to tell me what he wants,” “He doesn’t know all those words,” “That’s too much for him,” “He doesn’t need all that,” “Oh, we know what he wants usually, he just needs to tell us when we’re wrong.” “He can’t use all that.” “He just needs the names of the things he wants to ask for.”

Well, he needs to tell you more than what he wants. What about when he doesn’t feel well, when something is wrong, when something particularly good/bad has happened, when he’s upset, when he wants to tell you he likes/doesn’t like something,…… shall I go on?

He’ll know those words when you teach them to him. It can be simplified to start and gradually get more complex as you teach him the words.

He needs all that if he is going to use all of the functions of communication. You can’t possibly always know what he wants, and what do you do when you’re wrong? He can use all that. He needs to do more than just request.

You need to presume competence. You need to think beyond grape juice vs orange juice. You need to think beyond puzzle vs movie. You need to believe that he can communicate a LOT; given the tools and the strategies to use them.

I am not going to name names here. I am not going to tell you that apps a, b, and c are good apps, but that x, y, and z apps are bad.

What I am going to tell you is that a “good” AAC app is

based on core vocabulary; it emphasizes the use of and easy access to high frequency words

offers sufficient vocabulary range that can grow with the child and work for him now and into the foreseeable future, so that you are not going to have to change apps some day (and he will have to learn all over again where the words are)

offers sufficient vocabulary to meet all communication needs and functions; including word-based and some phrase-based options

offers sufficient vocabulary so that the communication partners can use Aided Language Stimulation or Aided Input for all the things they are saying to the student

has a ‘hidden’ button feature that allows you to temporarily hide some vocabulary he is not yet using, but will need

can change the size of the layout/array

can change color coding if needed; especially for access

offers morphology and syntax features; such as creating plurals, possessives, and verb tenses

offers a range of page sets to meet a variety of needs and skills, and an easy way to move from one page set to the next without having to start over with customizing vocabulary

offers choices of voices

is easy to use not just when the student is at the 1-2 word stage, but is just as easy to use to construct complete sentences

the company that developed it offers customer support

it offers a keyboard with text-to-speech so that the student can learn literacy skills and talk about them

allows photos to be imported (because really, who in your family looks like those stick figures?)

allows for switch scanning access if this is a feature your user needs

allows for backups to be made so that customizations aren’t lost in case of a technology failure, or so that support staff can make customizations and easily save and send them to the user

If I've left something off of the list, I trust someone out there will tell me. I'm still fighting with my health post-surgery, so just not the sharpest tack in the box right now.

Next week, I'm planning to talk about where to begin. In the meantime, Keep on Talking!

Monday, July 25, 2016

In my last post I talked about the dedicated AAC devices that are available in the market. I alluded to the fact that the number of these devices and the companies that make them have been shrinking with the popular use of iPads as AAC devices.

So, let’s talk a little bit about the iPad as an AAC device. First and foremost, let me emphasize two things:

use of an iPad as an AAC device should mean that it is being treated as a dedicated AAC device. That is, the AAC app is all that is on that iPad. It is not used for leisure activities. It is not used for academic activities. It is a way to communicate. Nothing else. Because, no matter whatever else the student is doing at any given time, he needs to be able to quickly communicate whatever he wants to say without having to exit what he’s doing, find his AAC app, and open it to use it

and,

2. use of a robust AAC app. One that is not just a choice board. One that offers a full range of vocabulary and flexibility in page settings, array size, and button settings. There are too many AAC apps on the market that are not much better than basic choice boards. And I’ve seen robust AAC apps reduced to simple choice boards by partners who just don’t know what else they’re supposed to do.

I’ll come back to the discussion of apps next time. For now, let’s just talk about why iPads are - or are not - a good choice as an AAC system.

There are some good reasons for using an iPad as an AAC device.

They are significantly less expensive than dedicated devices.

They are lightweight and easily portable.

They can be purchased by many families; obviating the need for protracted battles with insurance companies or school districts over providing a dedicated device. And many districts are happy to purchase an iPad for a child for AAC; happy to be avoiding the $8K pic ticket of a dedicated device.

And - a deal maker or breaker for many children and adolescents - everyone has one, so they don’t look different or stand out.

There are also some reasons why iPads are not for everyone as an AAC solution.

They come with a very limited warranty and virtually no options when the screen cracks or shatters.

The touch screens on iPads are very sensitive. I call them the “Goldilocks” of touch screens. You have to hit it just right. For many of our students it can be frustrating to touch and touch and not have it work. And while the access features do help many students with an alternate point response, it doesn’t work for everyone.

There is no way to securely attach a key guard. I have velcro dots on one of my cases to hold my key guard to my iPad. It’s not an effective solution for even a brief evaluation. I have wrapped velcro straps around the device to hold the key guard on. Also not consistently effective. For kids with spasticity, especially, key guards are not secure on an iPad.

If anyone has found a better way, I’d love to hear it!

Remember, it is important to get a competent AAC evaluation before you make a choice of AAC system. A knowledgeable SLP will know the features, drawbacks, and advantages of the entire range of possibilities for a specific user.

A good evaluation will highlight the user's needs, strengths and weaknesses, and will point to specific features that fit that profile.

While good, effective intervention is crucial in developing communication skills no matter what system you choose, choosing that system should be a considered, educated decision.

Sunday, July 10, 2016

With seemingly everyone using iPads with AAC apps these days, you might think there aren’t any dedicated SGD (speech generating devices) still around, nor any good reasons to pay (or have your insurance pay) $5,000 to $9,000 (or more) for one.

But both assumptions would be a mistake. Despite the many changes and downturns in the industry, there are still some AAC device manufacturers out there alive and kicking. And there are some excellent reasons for using one of them; rather than the ubiquitous iPads.

1. Saltillo is the maker of the Nova Chat range of devices; with 5”, 8”, 10”, and 12” screen sizes, as well as the Fusion models with head pointing and advanced scanning options for alternate access.

Many users - as well as school districts - use the app version of the software (Touch Chat) on iPads rather than purchasing dedicated devices.

But iPads don’t come with the company’s 3 year warranty.

2. Prentke-Romich Co. (PRC) continues to make their specialized dedicated devices with Semantic Compaction language system and use of core words. I love to recommend PRC devices to young children who haven’t had a ton of exposure to other symbol systems yet, and who appear to have a good support system.

PRC devices use a closed set of Unity symbols, feature syntactic prediction and use limited navigation. Unity uses a relatively small symbol set, representing core words, that can be combined endlessly into genuine messages, in the natural way we all speak.

Core words are on the front page and easily accessible. They never move, or are found in different locations on other pages. Unity symbol placement allows for learning based on motor patterns. There are also symbols and spaces for fringe vocabulary.

Their Accent devices come with 8, 10, or 14” screens.

They, too, have an app: LAMP Words for Life, that offers their 84-location page set. with hide-able buttons.

3. Tobii-Dynavox continues to product some of both the Tobii and Dynavox line of products, while having eliminated some since Tobii bought out Dynavox. Toby now has a line of tablet-based devices with 7, 10, 15, and 8” screens. They also have a line of eye-gaze technologies from integrated eye gaze systems to portable units that can be added to standard PCs.

Tobii's Sono Flex and Dynavox's Compass apps are also available for the iPad.

I see a fair number of students whose physical disabilities are significant enough to require use of eye gaze for communication. I push use of partner assisted scanning (PAS) as a back-up strategy or mode, since eye gaze use is fatiguing, and it takes a while to become proficient.

I have a preference for the Tobii and PRC systems; based mostly on the numbers of clients I see who calibrate more consistently or easily with one of these two systems as opposed to others.

Bonus 4: Zygo also continues to produce dedicated devices and uses the highly developed Grid software for AAC. heir Grid Pad line comes in 8, 10, 11, 13, ad 18” screens. It is also available with an eye gaze unit which, I confess, I have not tried.

It is important to note that the android tablets upon which most of these devices are based have less “finicky” touch screens than iOS devices, making them a better choice for students who have difficulty with activating the iPad screen. For those students with fine motor difficulties who need key guards, there are key guards that snap onto them and stay secure.

There are some other devices available in the marketplace. Because most of the clients I see go through their insurance for purchase of a dedicated device, I tend to only work with those companies whose devices can be paid for through medical insurance. That has always ruled out some smaller companies that don’t have funding departments and aren’t approved by Medicaid (here, in my case that’s Medi- Cal).

So, while this list is hardly exhausting, or even detailed about those devices I do list, I hope I’ve opened some of your eyes to iPad alternatives, and to the reasons why we still use dedicated devices in AAC.

I can’t stress enough the need for a comprehensive AAC evaluation to determine the most appropriate device and/or system for your student. Often iPads that are dedicated to AAC (have no other apps on them and are not used for education or leisure) are perfectly fine AAC solutions. However, that is not always the case, and providing only iPads without considering those factors can be dangerous.

Sunday, July 3, 2016

Apologies to any of you who missed me last week. I just never managed to get a post written.I’m healing well enough (albeit a bit behind on muscle strength), but the rest of me - well, not so much. Sleep patterns are still totally disrupted and no sleep makes me….well, just plain out of it!I seem to spend a lot of time sitting and just staring - at nothing in particular. But, day by day, it’s getting there.So, this week, I vowed to be better tuned in and on top of things. I was only partially successful, but here I am on Friday putting together a post for this weekend.It’s a big holiday weekend. Will any of you be around to read this? I, for one, have no plans. And I plan on keeping it that way.

Where ever you are let me help you plan your activities with the AAC user(s) you support, by offering up this simple planning sheet.Aided Language Stimulation, Aided Input, whatever form of modeling you are doing with your AAC user, often requires some planning if it’s something you’re new to doing. Getting familiar with the aac system you’re going to be using is imperative, but sometimes easier said than done. So, with the though of integrating it one activity at a time, take the time to think about what words go with that activity. What words will you need to use? And don’t just plan for making choices or requests. Think about describing, commenting, asking questions.Here is simple example, using my all-time favorite activity: blowing bubbles.Until next week, keep on talking - and modeling!

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